RUTH BERMUDEZ MONTENEGRO, Magistrate Judge.
Plaintiff Timothy K. ("Plaintiff") filed a Complaint pursuant to 42 U.S.C § 405(g) seeking judicial review of the final decision of the Commissioner of the Social Security Administration ("Defendant") denying Plaintiff's application for Disability Insurance Benefits and Supplemental Security Income under Titles II and XVI of the Social Security Act (the "Act"). (Doc. 1.) Before the Court are: Plaintiff's Motion for Summary Judgment, seeking reversal of the Commissioners final decision and an award of social security disability and supplemental security income benefits, or alternatively, remand to the Social Security Administration for further proceedings (Doc. 15); Defendant's Cross-Motion for Summary Judgment and Opposition to Plaintiff's Motion for Summary Judgment (Doc. 22); Plaintiff's Reply to Defendant's Opposition to Plaintiff's Motion for Summary Judgment (Doc. 25); and Defendant's Reply in Opposition to Plaintiff's Reply and Opposition to Defendant's Cross-Motion for Summary Judgment and in Support of Defendant's Motion for Summary Judgment (Doc. 27).
The matter was referred to the undersigned for Report and Recommendation pursuant to 28 U.S.C. § 636(b)(1)(B) and Civil Local Rule 72.1(c)(1)(c). After a thorough review of the papers on file, the Administrative Record ("AR"), and the applicable law, this Court respectfully recommends that Plaintiff's Motion for Summary Judgment be
On November 1, 2013, Plaintiff filed an application for disability and disability insurance under Title II of the Act (AR, at 195-199
On November 3, 2016, the ALJ issued a written decision in which he determined that Plaintiff was not disabled as defined in the Act. (AR, at 52-62.) On January 2, 2017, Plaintiff sought review of the decision by the Appeals Council. (AR, at 192-194.) On December 12, 2017, the Appeals Council denied review of the ALJ's ruling, and the ALJ's decision became the final decision of the Commissioner pursuant to 42 U.S.C. § 405(h). (AR, at 4-10.)
In his decision, the ALJ initially determined Plaintiff met the insured status requirements of the Act through December 31, 2018. (AR, at 54.) The ALJ then followed the five-step sequential evaluation process to determine whether Plaintiff is disabled. See 20 C.F.R. §§ 404.1520(a), 416.920(a).
At step one, the ALJ found Plaintiff had not engaged in substantial gainful activity since November 29, 2014, the alleged onset of disability
At step two, the ALJ found Plaintiff suffers from the following severe impairments: degenerative disc disease of the spine, degenerative joint disease, and headaches. (AR, at 54.)
At step three, the ALJ found Plaintiff did not have an impairment or combination of impairments that meets or medically equals the severity of one of the impairments listed in 20 CFR Part 404, Subpart P, Appendix 1. (AR, at 57.)
Next, the ALJ determined Plaintiff has the residual functional capacity ("RFC") to perform light work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), "except that he is further limited to occasional postural activity, such as climbing, stooping, kneeling, crouching, and crawling." (AR, at 58.)
For purposes of his step four determination, the ALJ gave great weight to the VE's testimony that Plaintiff had worked as a "supervisor, maintenance for installation[,] [Dictionary of Occupational Titles ("DOT")] code 891.137.010," and that a hypothetical person with Plaintiff's vocational profile would be able to perform the exertional demands of Plaintiff's past work. (AR, at 62; 95-96.) The ALJ found Plaintiff "is capable of performing past relevant work as an insulation supervisor." (AR, at 61.)
Accordingly, the ALJ found Plaintiff "had not been under a disability, as defined in the [Act], from November 29, 2014, through the date of []his decision...." (AR, at 62.)
As set forth in the moving and opposition papers, the disputed issues are as follows:
1. Whether the ALJ properly considered the medical evidence and assessed an RFC consistent with the record as a whole. (Doc. 15-1, at 3-5; Doc. 23, at 9-18.)
2. Whether the ALJ properly found Plaintiff capable of performing his past relevant work. (Doc. 15-1, at 5-6; Doc. 23, at 18-20.)
3. Whether the ALJ properly weighed the opinion of Plaintiff's treating physician, Arsenio Jimenez, M.D. (Doc. 23, at 15-18; Doc. 25, at 3-4.)
The Act provides for judicial review of a final agency decision denying a claim for disability benefits in federal district court. 42 U.S.C. § 405(g). "As with other agency decisions, federal court review of social security decisions is limited." Treichler v. Comm'r Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014). A federal court will uphold the Commissioner's disability determination "unless it contains legal error or is not supported by substantial evidence." Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014) (citing Stout v. Comm'r Soc. Sec. Admin., 454 F.3d 1050, 1052 (9th Cir. 2006)). Substantial evidence means "more than a mere scintilla, but less than a preponderance; it is such relevant evidence as a reasonable person might accept as adequate to support a conclusion." Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007); Morgan v. Comm'r Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 2003).
In reviewing whether the ALJ's decision is supported by substantial evidence, the Court must consider the record as a whole, "weighing both the evidence that supports and the evidence that detracts from the Commissioner's conclusion." Lingenfelter, 504 F.3d at 1035 (quoting Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998)). The ALJ is responsible for "determining credibility, resolving conflicts in medical testimony, and for resolving ambiguities." Garrison, 759 F.3d at 1010 (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)).
When the evidence is susceptible to more than one rational interpretation, the ALJ's conclusion must be upheld. Batson v. Comm'r Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004); see also Ryan v. Comm'r Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008). Stated differently, when the evidence "can reasonably support either affirming or reversing a decision, [the Court] may not substitute [its] judgment for that of the [ALJ]"; rather, the Court only reviews "the reasons provided by the ALJ in the disability determination and may not affirm the ALJ on a ground upon which he did not rely." Garrison, 759 F.3d at 1010 (quoting Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003)). Further, when medical reports are inconclusive, questions of credibility and resolution of conflicts in the testimony are the exclusive functions of the ALJ. Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). It is not within the Court's province to reinterpret or re-evaluate the evidence, even if a re-evaluation may reasonably result in a favorable outcome for the plaintiff. Batson, 359 F.3d at 1193.
Plaintiff submitted medical reports from two state consultative examiners, Thomas J. Sabourin, M.D. and Zavan Bilezikjian, M.D., both orthopedic specialists, to support Plaintiff's claim of disability. Dr. Bilezikjian recommended several postural and exertional limitations, but the ALJ failed to address those additional limitations in the decision.
Plaintiff contends the ALJ's RFC determination is not supported by the record as a whole because the ALJ failed to identify any reasoning for rejecting the additional limitations by Dr. Bilezikjian. (Doc. 15, at 3.) Defendant responds that the ALJ's RFC determination is supported by the record as a whole because he gave greater weight to two consistent orthopedic specialist consultative examiners' opinions, the physical examination findings, and the overall treatment regimen. (Doc. 23, at 3.) For the reasons outlined below, the Court finds that the ALJ erred by failing to provide specific, legitimate reasons for rejecting Dr. Bilezikjian's additional limitations.
An ALJ is not required to accept each limitation recommended by physicians. Ryan, 528 F.3d at 1198. But "[i]f a treating or examining doctor's opinion is contradicted by another doctor's opinion, an ALJ may only reject it by providing specific and legitimate reasons that are supported by substantial evidence." Id. "This is so because, even when contradicted, a treating or examining physician's opinion is still owed deference and will often be entitled to the greatest weight ... even if it does not meet the test for controlling weight." Garrison, 759 F.3d at 1012 (internal citations and quotations omitted). An ALJ can satisfy the substantial evidence requirement by "setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Reddick, 157 F.3d at 725. "The ALJ must do more than state conclusions. He must set forth his own interpretations and explain why they, rather than the doctors', are correct." Id. (internal citations omitted).
When an ALJ does not explicitly reject a medical opinion or set forth specific, legitimate reasons for crediting one medical opinion over another, he errs. See Nguyen v. Chater, 100 F.3d 1462, 1464 (9th Cir. 1996.) "In other words, an ALJ errs when he rejects a medical opinion or assigns it little weight while doing nothing more than ignoring it, asserting without explanation that another medical opinion is more persuasive, or criticizing it with boilerplate language that fails to offer a substantive basis for his conclusion." Garrison, 759 F.3d at 1012-13.
Plaintiff submitted reports from Dr. Sabourin (AR, at 445-449) and Dr. Bilezikjian (AR, at 475-479) in advance of his administrative hearing.
Dr. Sabourin's report reads, in relevant part:
(AR, at 445.)
Dr. Bilezikjian's report reads, in relevant part:
(AR, at 479.)
Both opinions are partially consistent in that each physician recommends exertional and postural limitations; however, the opinions are inconsistent because the standing, walking, and sitting limitations are vastly different. While Dr. Sabourin found Plaintiff can stand and walk for six hours of an eight-hour day, Dr. Bilezikjian found Plaintiff can only stand or walk for two hours of an eight-hour day. (AR, at 449, 479.) While Dr. Sabourin did not opine as to Plaintiff's ability to sit, Dr. Bilezikjian found that Plaintiff can only sit for six hours of an eight-hour day with regular changes of position. (Id.) While Dr. Sabourin found that Plaintiff can climb occasionally, Dr. Bilezikjian found that Plaintiff could not climb ladders or walk on uneven terrain. (Id.) In sum, whereas Dr. Sabourin's conclusions are consistent with light work, Dr. Bilezikjian's conclusions are consistent with sedentary work. See 20 C.F.R. §§ 404.1567, 416.967. Therefore, Dr. Sabourin's and Dr. Bilezikjian's opinions are inconsistent.
The ALJ's RFC determination failed to identify and address the inconsistencies in Dr. Sabourin and Dr. Bilezikjian's postural and exertional recommendations when determining Plaintiff's RFC.
The ALJ wrote:
(AR, at 61.)
Even though the ALJ specifically analyzed Dr. Bilezikjian's clinical findings, the decision is silent as to Dr. Bilezikjian's additional exertional and postural limitations. The ALJ cited Dr. Bilezikjian's opinions as to Plaintiff's general appearance, station and gait, cervical spine examination, thoracolumbar spine examination, straight-leg raising test, examination of extremities and joints, neurologic examination, radiographic examination, and Dr. Bilezikjian's diagnostic impressions. (AR, at 60.)
During the administrative hearing, the ALJ questioned the VE as to the additional limitations:
(AR, 95-96.) Based on this line of questioning, the ALJ was aware of Dr. Bilezikjian's additional standing limitation. In spite of that awareness, the ALJ did nothing more than ignore the standing limitation in his decision. Garrison, 759 F.3d at 1012.
By failing to identify and consider the inconsistencies between the consultative examiners' opinions, ignoring the additional postural and exertional limitations set forth by Dr. Bilezikjian, and failing to provide specific, legitimate reasons supported by substantial evidence for doing so, the ALJ erred. Ryan, 528 F.3d at 1198; Nguyen v. Chater, 100 F.3d 1462, 1464 (9th Cir. 1996). Accordingly, Plaintiff is entitled to remand on this ground so the ALJ may have an opportunity to address Dr. Bilezikjian's additional limitations directly. See Law v. Colvin, 657 Fed.Appx 655 (9th Cir. 2016) (remanding for further proceedings rather than for award of benefits because "further administrative proceedings would be useful[.]").
Plaintiff contends the ALJ erred because he misidentified the DOT listing associated with Plaintiff's most recent job, thereby erroneously finding that Plaintiff could return to his past work. (Doc. 15, at 5-6.) Defendant responds that the ALJ correctly identified the DOT listing for Plaintiff's past work, that Plaintiff has waived the issue by failing to object at the administrative hearing, and that even if the ALJ erred, the error was harmless because both DOT listings fall within the same RFC. (Doc. 23, at 13-14.)
Before making a disability determination, the ALJ takes "administrative notice of reliable job information available from various governmental and other publications," such as the DOT. 20 C.F.R §§ 404.1566(d), 416.966(d). Additionally, the ALJ may rely on an impartial vocational expert to provide testimony about jobs the applicant can perform despite his or her limitations. See Gutierrez v. Colvin, 844 F.3d 804, 806-807 (9th Cir. 2016.) But if a reviewing court cannot determine an ALJ's reasoning in arriving at a step four determination, remand is the appropriate remedy. See Brynes v. Shalala, 60 F.3d 639, 642 (9th Cir. 1995).
As outlined below, there are serious discrepancies between Plaintiff's work history report, the VE's testimony, and the ALJ's decision with respect to Plaintiff's prior work. Plaintiff's work history report and testimony indicates he worked as a supervisor, installation (construction), corresponding to DOT code 863.134-014. (AR, at 76-77, 240-241.) But, the VE classified Plaintiff's prior work as a maintenance supervisor, corresponding to DOT code 891.137-010. (AR, at 96-97.) Finally, the ALJ classified Plaintiff's prior work as an insulation supervisor, a job which has a strength rating that exceeds Plaintiff's RFC. (AR, at 63.) Because the record is unclear as to the classification of Plaintiff's prior work, the Court cannot determine whether the ALJ's step four decision (i.e., whether Plaintiff can return to past work) is based on substantial evidence.
Plaintiff's work history report indicates he held two jobs: supervisor of installation, and insulation installer. (AR, at 240-241.) As a supervisor of installation, Plaintiff: "organized, planned, supervised, and staff[ed] on a daily basis[, and] [o]versaw [and] ensured accurate [and] complete [] contract progects [sic] daily." (AR, at 240.) As an insulation installer, Plaintiff: "installed pipe [and] duct insulation for thermal considerations[;] [t]ransported all material [and] tools to and from each job[; and] [l]ocalized all tools [and] materials on site." (AR, at 240-21.) At the administrative hearing, Plaintiff testified that as an installation supervisor, he performed the following work:
(AR, at 76-77.)
At the administrative hearing, the ALJ examined the VE to determine Plaintiff's prior work and whether Plaintiff could return to his prior work:
(AR, at 95-96.)
However, the VE misclassified Plaintiff's prior work. The job title corresponding to DOT code 891.137-010 is maintenance supervisor (any industry), alternatively titled building-and-grounds supervisor; building maintenance supervisor, mechanical; and building supervisor. (DOT code 891.137-010.) The duties are listed as:
(Id.) None of these job responsibilities are related to Plaintiff's prior work history, except for supervision of workers engaged in repairing building heating and ventilating systems; and in that aspect, Plaintiff's prior work history is related only loosely. (Compare AR, at 76-77, 240-241 with DOT code 891.137-010.)
The ALJ misinterpreted the VE's testimony in classifying Plaintiff's past work. Finding that Plaintiff can return to his previous work, the ALJ reasoned:
(AR, at 62.)
Whereas the VE classified Plaintiff's prior work as "maintenance supervisor," the ALJ classified Plaintiff's prior work as "insulation supervisor." But "insulation supervisor" is not a title corresponding to DOT code 891.137-010. The job title to which the ALJ refers, insulation supervisor, is listed as an alternate title to building-insulation supervisor, corresponding to DOT code 863.134-010. (See Doc. 15, at 6; DOT code 863.134-010.) An insulation supervisor:
(Id.) The job of building-insulation supervisor has a physical demands strength rating of light, and an SVP requirement of 7. But, as Plaintiff points out, there is another job containing the words "insulation" and "supervisor:" supervisor, installation (construction), corresponding to DOT code 863.134-014. (See Doc. 15, at 6; DOT code 863.134-014.) The duties are listed as:
(Id.) These job duties parallel the duties Plaintiff listed in his work history report and testified to at the administrative hearing. But the job of supervisor, installation (construction) has a physical demands strength rating of medium, and an SVP requirement of 8—which exceeds the exertional and strength requirements of ALJ's RFC determination. (Id.)
The discrepancies in classifying Plaintiff's past work make it impossible to determine whether Plaintiff can return to past work, as the varying classifications impose different exertional and strength requirements. Due to the ambiguity in the ALJ's decision as to Plaintiff's prior work, the Court cannot determine the ALJ's reasoning with certainty to weigh "both the evidence that supports and the evidence that detracts from the Commissioner's conclusion." Lingenfelter, 504 F.3d at 1035. Therefore, the Court cannot determine whether the ALJ's decision finding Plaintiff can return to past work is supported by substantial evidence. Accordingly, Plaintiff is entitled to remand on this ground. See Brown v. Astrue, 267 Fed.Appx 620, 622 (9th Cir. 2008) (explaining that remand is the appropriate remedy where the VE's testimony was unclear); Brynes, 60 F.3d at 642 (remanding for further proceedings because the Court could not determine the ALJ's reasoning).
Plaintiff submitted the report of his treating physician, Dr. Jimenez, in support of his application. (AR, at 700-701.) Dr. Jimenez opined that Plaintiff was limited to less than sedentary work, and recommended significant postural and exertional limitations. (Id.) However, the ALJ gave minimal weight to Dr. Jimenez' opinion. (AR, at 61.) Plaintiff contends the ALJ failed to properly weigh Dr. Jimenez' opinion by failing to review all the factors enumerated in 20 C.F.R. § 404.1527. (Doc. 25, at 3-4.) Defendant responds that the ALJ properly weighed Dr. Jimenez's opinion because Dr. Jimenez's opinion was inconsistent with Dr. Sabourin's and Dr. Bilezikjian's findings, Dr. Jimenez was not a specialist, and Plaintiff's overall conservative treatment, imaging evidence, and testimony did not support Dr. Jimenez's opinion. (Doc. 23, at 15-18.) The Court finds that the ALJ properly considered the pertinent regulatory factors in rejecting the opinion of Plaintiff's treating physician.
The uncontradicted opinion of a treating physician is generally entitled to controlling weight. 20 C.F.R. §§ 404.1527(d)(2), 416.927(d)(2); Wilson v. Comm'r of Soc. Sec., 303 Fed.Appx. 565, 566-67 (9th Cir. 2008). Even when a treating physician's opinion is contradicted by that of another physician, it can only be rejected if an ALJ provides specific and legitimate reasons that are supported by substantial evidence in the record. Aranda v. Comm'r Social Sec. Admin., 405 Fed.Appx. 139, 140 (9th Cir. 2010). The ALJ is required to consider the factors set out in 20 C.F.R. § 404.1527(c)(2) to (6) in determining how much weight to afford the treating physician's medical opinion. Ghanim v. Colvin, 763 F.3d 1154, 1161 (9th Cir. 2014). Those factors include:
Orn v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007); 20 C.F.R. § 404.1527(d)(1)-(6). The failure to consider these factors constitutes reversible legal error. Trevizo v. Berryhill, 871 F.3d 664, 676 (9th Cir. 2017).
However, "courts in our district have held that Trevizo does not `demand a full-blown written analysis of all the regulatory factors; it merely requires some indication that the ALJ considered them.'" Kovach v. Berryhill, 2019 WL 2995824, at *12 (S.D. Cal., July 9, 2019) (quoting Hoffman v. Berryhill, 2017 WL 3641881, at *1, *4 (S.D. Cal. Aug. 24, 2017) report and recommendation adopted by 2017 WL 4844545 (S.D. Cal. Sept. 14, 2017) (citing Yantos v. Berryhill, 2018 WL 899126, at *1, *6 (S.D. Cal. Feb. 14, 2018) ("[T]he Ninth Circuit has never compelled such a specific analysis. The ALJ is certainly required to consider all of the factors, but the regulations and rulings contain no requirement that each and every factor be specifically analyzed in an ALJ's decision.")).
Here, the record indicates the ALJ considered the regulatory factors in 20 C.F.R. §§ 404.1527 and 416.927 in rejecting the opinion of Plaintiff's treating physician. The ALJ writes:
(AR, at 61.) Additionally, the ALJ specifically wrote that he "considered opinion evidence in accordance with the requirements of 20 C.F.R. §§ 404.1527 and 416.927 and SSRs 96-2p, 96-5p, 96-6p, and 06-3p." (AR, at 58.) Based on the record, the ALJ properly considered the factors in 20 C.F.R. §§ 404.1527 and 416.927 to discount Dr. Jimenez' opinion on the grounds that the opinion was inconsistent with the record as a whole, Dr. Jimenez was not a specialist, and Plaintiff's overall conservative treatment regimen, imaging evidence, and testimony did not support the opinion. Thus, the ALJ provided specific and legitimate reasons for discounting Dr. Jimenez' opinion which are supported by substantial evidence in the record, and considered the factors enumerated in 20 C.F.R. §§ 404.1527 and 416.927. Aranda v. Comm'r Social Sec. Admin., 405 Fed.Appx. 139, 140 (9th Cir. 2010). Accordingly, Plaintiff is not entitled to remand on this ground.
This Report and Recommendation is submitted to United States District Judge Anthony J. Battaglia pursuant to 28 U.S.C § 636(b)(1) and Federal Rule of Civil Procedure 72(b). For the foregoing reasons, this Court respectfully recommends that Plaintiff's Motion for Summary Judgment be